Extracranial Carotid Disease and Effect of Intra-arterial Treatment in Patients With Proximal Anterior Circulation Stroke in MR CLEAN.

Annals of Internal Medicine
O A BerkhemerMR CLEAN investigators

Abstract

The presence of extracranial carotid disease (ECD) is associated with less favorable clinical outcomes in patients with acute ischemic stroke caused by intracranial proximal occlusion. Acute intra-arterial treatment (IAT) in the setting of extracranial and intracranial lesions is considered challenging, and whether it yields improved outcomes remains uncertain. To examine whether the presence of ECD modified the effect of IAT for intracranial proximal anterior circulation occlusion. Prespecified subgroup analysis of a randomized clinical trial of endovascular treatment for acute ischemic stroke in the Netherlands. (Trial registrations: NTR1804 [Netherlands Trial Register] and ISRCTN10888758). 16 hospitals in the Netherlands. Acute ischemic stroke caused by proximal intracranial arterial occlusion of the anterior circulation. Extracranial carotid disease was defined as cervical internal carotid artery stenosis (>50%) or occlusion. IAT treatment versus no IAT. The primary outcome was functional outcome, as measured by the modified Rankin Scale at 90 days and reported as adjusted common odds ratio (acOR) for a shift in direction of a better outcome. Multivariable ordinal logistic regression analysis with an interaction term was us...Continue Reading

Citations

Jan 20, 2018·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·U Sadeh-GonikB Gory
Mar 27, 2018·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·B GoryUNKNOWN Thrombectomy In TANdem lesions (TITAN) investigators
Nov 8, 2019·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·Alexandra R PaulAlan S Boulos
Oct 13, 2017·Journal of Neurointerventional Surgery·Zarina AssisUNKNOWN ESCAPE Trialists
Apr 21, 2018·AJNR. American Journal of Neuroradiology·A M M BoersUNKNOWN MR CLEAN investigators
May 11, 2018·Clinical Neuroradiology·Pervinder BhogalLeonard Yeo
Sep 2, 2017·Current Atherosclerosis Reports·Konark MalhotraGeorgios Tsivgoulis
Jun 19, 2021·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Marcelo RochaAshutosh P Jadhav

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